374603344-12-2-2025-08-AS-MGCO-DNZ4Z4-20251202183205

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 374603344
Report Date: 12/02/2025
Date Signed: 12/02/2025 06:34:23 PM

Document Has Been Signed on 12/02/2025 06:34 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO RO, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108

FACILITY NAME:	A WINSOME ASSISTED LIVING COMMUNITY		FACILITY NUMBER:	374603344
ADMINISTRATOR/ DIRECTOR:	GUIA IGBANTE-ENRIQUEZ		FACILITY TYPE:	740
ADDRESS:	3808 SWEETWATER ROAD		TELEPHONE:	(619) 434-6560
CITY:	BONITA	STATE: CA	ZIP CODE:	91902
CAPACITY: 6		CENSUS: 5	DATE:	12/02/2025
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	08:50 AM
MET WITH:	House Manager, Jessica Enriquez		TIME VISIT/ INSPECTION COMPLETED:	11:40 AM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	Licensing Program Analyst (LPA) Marisela Garcia-Centeno conducted an unannounced Required Annual Inspection. The facility file was reviewed prior to the visit. LPA identified herself and was granted entry by Caregiver Irma Sunga. LPA explained the purpose of the visit to House Manager Jessica Enriquez. The facility is licensed for a maximum capacity of six (6) residents, age 60 and above, with one (1) bedridden resident permitted in Room #5 only. At the time of inspection, five (5) residents were in care, including one (1) ambulatory resident. Three (3) residents were present in the facility, and two (2) were out in the community. The facility does not have delayed egress devices or a secured perimeter. LPA toured the interior and exterior of the facility with Caregiver Sunga. Resident rooms were inspected and found to contain the required furnishings. Pathways were free of obstructions and slip hazards. The facility was clean, well-maintained, and in good repair. Doors, toilets, and showers were operational. Adequate hygiene supplies and extra linens were available. Sufficient space and equipment were observed for dining, laundry, visitation, meetings, and resident activities. Indoor temperature and refrigerator/freezer temperatures were within the regulatory range. During the inspection, LPA measured the hot water temperature at 130.5°F, which was not within the Title 22 regulatory range for Residential Care Facilities for the Elderly (RCFEs). Staff adjusted the temperature during the visit to bring it into compliance. (Continue at LIC809C)

NAME OF LICENSING PROGRAM MANAGER: Sabel Martinez
NAME OF LICENSING PROGRAM ANALYST: Marisela Garcia-Centeno
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 12/02/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/02/2025

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

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California Health & Human Services Agency

California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:

Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.

Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO RO, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108

FACILITY NAME: A WINSOME ASSISTED LIVING COMMUNITY	FACILITY NUMBER: 374603344
	VISIT DATE: 12/02/2025

NARRATIVE

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(Continue from LIC809)

The facility maintained at least a two-day supply of perishable food and a seven-day supply of non-perishable food, all properly stored. Cooking and dining equipment were available. No sharp objects, toxic chemicals, or open-faced heaters were accessible to residents. Medications were properly labeled and secured in locked storage.

The facility has a pool in the backyard. The pool gate was observed unlocked and accessible to residents. Residents confirmed they have access to the backyard area. Staff stated the gate is typically kept locked and that the gate was intended to automatically close all the way and lock. The House Manager locked the gate during the visit. House Manager Enriquez reported no firearms or ammunition on the premises.
Smoke alarms, carbon monoxide detectors, emergency lighting, and the facility telephone were operational. The fire extinguisher was purchased within the last 12 months (June 23, 2025). The first aid kit was complete and accessible. Required postings were observed in visible areas of the facility. The emergency drills were conducted each quarter as required; the last drill was conducted on September 28, 2025.

Confidential resident and staff records were reviewed and found properly stored and secured. Staff and resident interviews revealed no licensing concerns. Resident records contained required documentation. Staff files included current first aid certification. Staff provided proof of active business liability insurance and a surety bond. LPA provided technical assistance to the House Manager regarding maintaining complete records at the facility.

Deficiencies are cited per Title 22 regulations and documented on the attached LIC 809D. A $500 Civil Penalty for a Zero Tolerance violation regarding Accessible Bodies of Water is issued and noted on the attached LIC 421IM. A plan of correction (POC) was developed with Licensee, Guia Enriquez via telephone conference.

House Manager Jessica Enriquez received a copy of her Appeal Rights (LIC 9058 03/22). An exit interview was conducted, and copies of this report, LIC 809D, and LIC 421 IM were provided at the conclusion of the visit.

NAME OF LICENSING PROGRAM MANAGER: Sabel Martinez
NAME OF LICENSING PROGRAM ANALYST: Marisela Garcia-Centeno
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 12/02/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/02/2025

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 12/02/2025 06:34 PM - It Cannot Be Edited

Created By: Marisela Garcia-Centeno On 12/02/2025 at 12:39 PM

Link to Parent Document Below:

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108

FACILITY NAME: A WINSOME ASSISTED LIVING COMMUNITY	FACILITY NUMBER: 374603344
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 12/02/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type A

Section Cited

CCR

87303(e)(2)

Maintenance and Operation

(e) Water supplies and plumbing fixtures shall be maintained as follows: (2) Faucets used by residents for personal care such as shaving and grooming shall deliver hot water. Hot water temperature controls shall be maintained to automatically regulate the temperature of hot water used by residents to attain a temperature of not less than 105 degree F (41 degrees C) and not more than 120 degree F (49 degrees C). This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation and staff interviews the licensee did not comply with the section cited above, water temperature was exceeded Title 22 regulations. This posed and an immediate health and safety risks to five (5) persons in care.
	POC Due Date: 01/02/2026
	Plan of Correction
1 2 3 4	Licensee immediately adjusted the water temperature to comply with regulations. Licensee agreed to conduct staff training to ensure water temperature is checked and maintained as required and submit proof to LPA by POC due date.

Type A

Section Cited

CCR

87307(e)(2)(A)

Personal Accommodations and Services

(e) The licensee shall supervise residents as needed and as determined by the resident's appraisal pursuant to Section 87457, Pre-Admission Appraisal or Section 87463, Reappraisals, when residents are in proximity to or when there is use of the following items: (2) Fishponds, wading pools, hot tubs, swimming pools, or similar larger bodies of water. (A) The licensee shall ensure that the bodies of water specified above are inaccessible through fencing, covering, or other means when not in active use by residents. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observations and staff interviews, the licensee did not comply with the section cited above. The gate to the pool accessible to residents in care was not locked as required. This posed an immediate health and safety risk to five (5) residents in care.
	POC Due Date: 01/02/2026
	Plan of Correction
1 2 3 4	Licensee immediately adjusted locked the gate. Licensee agreed to have the gate repaired to ensure it locks automatically and conduct staff training to ensure the gate is checked and maintained locked as required and submit proof to LPA by POC due date.

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

	Sabel Martinez
NAME OF LICENSING PROGRAM MANAGER:

	Marisela Garcia-Centeno
NAME OF LICENSING PROGRAM ANALYST:

LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 12/02/2025

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/02/2025

LIC809 (FAS) - (06/04)

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